Background: Spiritual care in the neonatal intensive care unit (NICU) is needed to prevent the adverse effects of this crisis. This systematic review aims to identify spiritual care strategies in the NICU. Method: A literature search was conducted on international databases namely Embase, Medline, Proquest, SAGE, Science Direct, Scopus, and SpringerLink, from 2013 to 2023. The risk of bias was assessed using RoB2 and ROBIN I tools. Results: Nine studies were included. The meta-analysis revealed spiritual care reduce mother stress (SMD = −0.89 [-1.15, −0.63], p < 0.05, I2 = 80%) and reduce mother anxiety (SMD = −0.84 [-1.25, −0.42], p > 0.05, I2 = 0%) compared to the control group. Conclusion: This review presents the latest scientific evidence on spiritual care strategies in the NICU. However, the limited number of studies and high heterogeneity among outcomes should be of concern to nurses who will implement them. in the NICU. © 2024 Neonatal Nurses Association